Hypotonia - Symptoms, Causes and Treatments

What is Hypotonia?
Hypotonia is a medical condition, a disorder that causes low amount of tension and resistance to movements in the muscles, leading to reduction in muscle strength. Hypotonia in general is a disorder in itself but it is also looked at as a condition which is a sign of various disorders and indicates onset of problems related to muscle tone and/or motor nerve that controls movement and functioning of muscles. Diagnosis of hypotonia its early stage may help in treating the patient.

This disorder is also known as Floppy Baby syndrome or Benign Congenital Hypotonia or Amyotonia Congenita or Infantile Hypotonia etc.

What are the symptoms of Hypotonia?
Decreased muscle tone is the most prominent symptom of possible development of Hypotonia in a person. There are some other symptoms such as delay or problem in speech delivery, drooling, delay in response to any stimulation from the motor nerve that needs movement of joints or limbs, decreased strength, poor reflexes. A person with hypotonia disorder cannot properly support the upper part of body and leans forward for support, is affected by the development of a rounded shoulder posture, affected emotional and mental condition at some extent as compared to a person of the same age, uncontrolled movement/shaking of head or any other part of the body etc.

Hypotonia is also known as Floppy infant syndrome or infantile hypotonia as in most of the cases it is diagnosed during infancy. Infants who develop this condition often are considered to be rag dolls as the low muscle tone condition leads in development of floppiness in them as a result they do not have control on their body. They cannot stretch/flex ligaments for a longer period. Feeding becomes a problem for infants who develop this syndrome as they lose the ability to use muscles in their mouth to suck breasts properly.

As the children grow older, they develop the ability to stretch and use their muscles and ligaments in more ways. Children who develop hypotonia disorder witness delayed development such as learning to crawl, walk, lift hands, and respond to anything that needs movement of joints or limbs, problem in balancing their head etc. As mentioned above, speech difficulty is one of the problems children suffering from hypotonia develop.

What causes Hypotonia?
Genetic disorders such as Krabbe disease, Werding-Hoffman disease, Aicardi syndrome, Down syndrome, Achondroplasia, canavan disease, Riley-Day syndrome (also known as Familial dysautonomia), Griscelli syndrome, Leigh disease, Marfan syndrome, Rett syndrome, Prader-Willi syndrome, Myotonic dystrophy, Menkes syndrome, centronuclear and myotubular myopathy, Dejerine sottas syndrome, Septo-optic dysplasia, Tay-Sachs disease, 22q13 deletion syndrome, Trisomy 13 and FG syndrome etc. are the main conditions that causes hypotonia in infants/children.

There are many conditions leading to development of hypotonia, which are: muscular dystrophy, metachromatic leukodystrophy, infectious disease such as encephalitis, sepsis, meningitis, infant botulism, Guillain-Barre syndrome, poliomyelitis etc., myasthenia gravis, celiac disease, problems caused due to improper vaccination or abnormal reaction to vaccination, congenital cerebellar ataxia, congenital hypothyroidism, hypotonic cerebral palsy, teratogenesis (caused from utero exposure to Benzodiazepines), sensory integration dysfunction, dyspraxia, metabolic disorders such as hypervitaminosis (vitamin poisoning or vitamin overdose), rickets and kernicterus, problems with central nervous system dysfunction, any kind of brain injury that had direct or indirect effect on the nervous system (brain injury caused in an accident or injury caused in a child suffering from shaken baby syndrome), motor neuron lesions etc.

How is Hypotonia diagnosed?
Physical examination can help in confirming some symptoms such as inability to flex muscles for longer time, delayed response to stimulations, delayed physical development, speech problems, feeding problem for an infant due to inability to suck breasts properly etc. If the disorder is thought to have affected brain then it is considered to be cerebral palsy, if the problem is related to muscles then it is called as muscular dystrophy.

Family medical history, CT scan, MRI scan, EEG (Electroencephalogram), genetic testing (which involve testing for abnormalities in genes, chromosome karyotyping etc.), blood test, electromyography muscle test, muscle and/or nerve biopsy, spinal taps (also known as lumbar puncture, used to collect cerebrospinal fluid for analysis) etc. are other tests used to diagnose Hypotonia disorder.

Treatment
Unfortunately, there is no known and approved treatment available to completely cure hypotonia. However, treatments for symptoms and exercise can help in improving condition for person suffering from this disorder. Children suffering from this disorder are given special trainings in order to help them strengthen their muscles and improve response mechanism; acupuncture is used in some cases to help activate affected muscles or nerves, physical and developmental therapies to help attain better motor control and overall strength in muscles etc., speech therapy, supportive therapies in case if the disorder is considered to be a manifestation of some other disorder, medications in order to help the patient suffering from other disorders which cause hypotonia etc. are used to help people suffering from hypotonia.